Phyllis Adams Member

• Change of ownership (CHOW) of large chain organization skilled nursing facilities and nursing homes, including Medicare and Medicaid enrollment, CMS 855A registration, licensure and certification survey issues, CMS regional office approvals and Medicare Tie-in notices, Medicare intermediary matters, State Medicaid enrollment and certification, licensure issues and risk assessment.
• Start–up CHOW of ASCs including CON requirements, CON applications, and CON appeals, BCBSM evidence of necessity (EON) applications and approvals, timing for ASC accreditation through JCAHO, AAAHC or other accrediting organizations, assistance with MDCH construction plan review and permit process, and initial certification surveys.
• Appeals of adverse determinations by Medicare as to the effective date of Medicare and Medicaid certification for CHOW or initial Medicare certification of health care facilities, including applicable Life Safety Code (LSC) compliance and certification issues for hospitals, skilled nursing facilities (SNFs) and ASCs.
• ASC buy-outs and restructuring transactions including compliance with state and federal anti-kickback laws and requirements, disclosure requirements, and related regulatory impact of reorganization.
• CON applications for acquisition, replacement and relocation of acute care and psychiatric hospital beds, nursing home beds (including CON approvals for special population beds for Alzheimer residents, hospice use or special religious needs), nursing home “green house” and new model design projects, Facility Innovative Design Supplement (FIDS) program issues under the Michigan Medicaid program.
• CON applications and representation as to CON covered clinical equipment, including CT scanner, MRI units, megavoltage radiation therapy (MRT) units and services, surgical services/operating rooms (hospital and ASC), diagnostic and therapeutic cardiac catheterization labs and rooms, open heart surgery programs, and PET scanners.
• CON appeals and representation of clients before the Michigan CON Commission and Standard Advisory Committees, membership on various CON informal task forces and CON workgroups, advise and counseling regarding development of CON strategies, including modifications to current CON Standards, preparation of CON position papers and related documents.
• Representation of long-term care and nursing home clients with respect to Medicare certification for skilled nursing facilities (SNFs), SNF operational and compliance issues, including assistance with development of SNF compliance programs and materials consistent with applicable OIG guidance and anti-fraud provisions of the Deficit Reduction Act (DRA).
• Nursing home/SNF management contracts and operational agreements, including management agreements for county medical care facilities, representation of REITs regarding nursing home/SNF properties and management issues, including regulatory matters related to foreclosure and termination of leases for nursing home/SNF operators/lessees.
• Assisted living licensure issues, including regulation of non licensed assisted living facilities, development of assisted living contracts, including food service contracts, personal care services agreements/private duty nursing service agreements, home for the aged (HFA) licensure and licensure of facilities as adult foster care facilities.
• CCRCs including initial registration under the Living Care Disclosure Act, disclosure statements, residency agreements, annual CCRC registration, operational issues, discrimination issues for CCRCs under the federal Fair Housing Act and applicability of state landlord-tenant and other laws.
• Imaging contracts and joint ventures including mobile routes and mobile imaging services for MRI, CT and PET scanning units; management contracts and operating agreements for management or operation of imaging centers and services; IDTF enrollment and requirements, initial certification of IDTFs and CMS 855B applications for IDTF billing.
• Acquisition of psychiatric hospitals, psychiatric hospital licensure and certification issues, preparation of CON applications related to addition of new psychiatric hospital beds, relocation of existing hospitals and services, and replacement psychiatric hospital facilities.
• Licensure and certification issues related to hospitals and nursing home facilities in Chapter 11 bankruptcy proceedings, coordination of nursing home facility closures and transition to closing, disposition of nursing home beds from nursing homes/SNFs subject to closure action, including disposition of CON, de-licensure and de-certification from participation in Medicare and Medicaid.
• Medicare provider-based determinations and issues and related licensure and compliance issues under State law for hospital outpatient departments and services, including surgical services and outpatient freestanding surgical outpatient facility requirements.

State Work Groups and Task Forces

• LeadingAge Michigan Continuing Care Policy Council, 2004—present
• Michigan Department of Community Health, Office of Public Health Preparedness, Long-term Care Task Force, 2007
• CON Commission Informal Workgroup on Psychiatric Beds and Services, June to November 2006  
• LeadingAge Michigan Task Force on Assisted Living Regulation, 2006
• LeadingAge Michigan Task Force on CON Standards for Nursing Homes, 2006
• LeadingAge Michigan Task Force on Regulation of Continuing Care Retirement Communities, 2006
• CON Special Task Force on CON Standards, 2002